Summary:
This is a special program about debunking some myths about bereavement
and grief. Guest on the program is Mal McKissock
who has many years of experience in bereavement and grief counselling.This
program was first broadcast on 11th June, 2001.

Transcript:Norman Swan:
Welcome to a Health Report special, with me, Norman Swan.
Unfortunately, all of us at some time will be bereaved; we’ll
lose someone close to us and experience grief.

Today’s program is about debunking some myths about bereavement,
grief and grieving and perhaps give you another way of thinking
about them. The person I’m talking to is bereavement counsellor,
note bereavement, not grief, Mal McKissock. Mal McKissock has
over 30 years experience in the field and works at the Bereavement
Care Centre in Sydney.

Among other things, you’ll hear that the Kubler-Ross idea
of stages of grief isn’t quite right; you’ll find
out what you should reasonably expect from your GP in the way
of help and that certainly not everyone who’s bereaved needs
professional assistance.

Mal McKissock: Linguistically,
bereavement is the condition, and grief is the emotional experience
of it. But you could say that grief therefore would be a response
to almost any sort of loss, whereas bereavement defines one sort
of loss. So how you react in your bereavement will be your grief.
So that’s why people grieve, but they don’t bereave.

Norman Swan: Tell me the extent
to which they go together.

Mal McKissock: If grief is
the internal response to a significant loss, then it seems to
me that you, unless there are severe psychiatric conditions, you
can’t not grieve. So they go together, so when anyone has
the death of a significant person then they’re likely to
experience some sort of grief. How that grief manifests depends
on any number of variables.

Norman Swan: I suppose one
of the key questions is the extent to which everyone who is bereaved
requires help.

Mal McKissock: Well lots of
people accommodate their grief very successfully in their existing
unit: family, community, what have you. But do they need more
specific help because they are bereaved? Sometimes yes, and that
would depend on the variables and the risk factors. But they don’t
necessarily need counselling and they don’t necessarily
need medicine, because they might get that help from a church,
from a neighbour, from a friend.

Norman Swan: Let’s go
through what you believe are some of the myths associated with
grief, particularly, and grieving.

Mal McKissock: Well I think
over the last couple of decades most people have read about or
heard about a sort of stage theory of grief.

Norman Swan: This is the Kubler-Ross
theory?

Mal McKissock: Yes. Well it
was there before Elisabeth, and it’s certainly been there
after her, and she sort of popularised it. It became popular because
it fitted I think into a medical model, or a linear way of seeing
the world, that you sort of go from diagnosis to prognosis, to
treatment, to intervention, so actually you’re meant to
be going uni-directionally. So stages meant that people could
predict moments in time, they could predict outcomes, but as a
result of that they seemed to be saying for lots of people that
they’re not going through the stages as quickly as they
should, inferring that the stages are sequential and predictable.
That’s the myth about grief, because grief isn’t sequential
and it’s certainly not predictable.

What we talk about these days is Chaos theory, which, still we’ve
got a science to rely on, but it gives us a greater, not only
understanding of, but a willingness to live with the unpredictable.
Most people when they talk to me about grief want to know how
long it should last, or they’ll make a comment, ‘Oh,
it’s been such-and-such time’. In other words, they’re
suggesting that there is a linear limit, and we’re saying,
No, that’s not true.

Norman Swan: Well they’re
hoping there’s going to be a linear limit as well, aren’t
they?

Mal McKissock: Well I think
the belief that there is, is stronger than the hope that there
is, because even a doctor or a bereaved person will say, ‘Oh,
but it’s been five months’, or ‘It’s been
five years’. In other words, indicating that shouldn’t
they be over it by now? That model I think has got in people’s
way, because that’s when we start treating grief as an illness
or bereavement as a disease, and it’s not. So when people
say, sort of give that linear time limit based on stage theory,
that they’re meant to be moving from denial to acceptance
or something like that, it doesn’t take into account the
myriad of variables that are in someone’s life.

Norman Swan: So describe this
Chaos a bit more, because it could be a bit too scary for somebody
to think, well if it’s all chaos, I’m not going to
go near that thank you very much.

Mal McKissock: The physicists
actually talk about a sort of butterfly effect, and what they
say, their words, that if a butterfly flaps its wings in the Amazon
jungle it changes the weather in Sydney, eventually. And what
they’re saying from the point of physics, and meteorology
that one butterfly flapping its wings changes atmospheric pressure
and therefore the ripple effect will actually change the weather
around the world. But what they don’t know is when the butterfly
is going to flap. Or the butterfly’s proximity to the ground
when it flaps, or how many are gathered in his name flapping simultaneously.
So they’re all unpredictable dependent variables. And what
we’re saying about grief, that’s exactly the same
in a family, that’s exactly the same in one human being
that we have these unpredictable dependent variables. And people
grieve according to those unpredictable dependent variables, not
according to Kubler-Ross or anyone else.

Norman Swan: So tell me about
these variables.

Mal McKissock: Well it could
be age, gender, day of the week, we’ve also got risk factors
that we’re looking at how close they were in terms of emotional
terms to the person who died, the sort of inter-dependency, the
nature of the death, how did that person die. I mean you could
just go on and look at the variables in any one person, and they’ll
all have some effect.

Norman Swan: I just want to
get the sense of this Chaos, or how valid the points are if you
like, in the Kubler-Ross theory. So do you go and touch acceptance,
come back and then go to denial? How does it work and are those
points around the circle valid?

Mal McKissock: I actually think
the language is passé, and if that means it’s invalid
I think it is. And I don’t want to sort of go too far into
Elisabeth Kubler-Ross’ version of it, because as I said,
she is one of many and what she did worked at the time. But I
think it’s what we’ve done with what she said that’s
the problem. That we’re holding it as a rigid, prognostic
plan that people should be moving quickly. So when we look at
the word ‘denial’ in medical terms we’re talking
about an ego defence mechanism, that’s unconscious and impervious
to reason. You know, it’s the sort of word you might apply
to an alcoholic who for a whole variety of reasons doesn’t
see that they have a drinking problem. If we apply that to a bereaved
person, we apply that denial, it’s as if they don’t
know, we’re implying they’re not registering that
this person is dead. And I think, well that’s not true,
I mean they’re not in denial, they’re more likely
to be protesting but they’ll use words that in communal
language sound like denial. When they say ‘No, it’s
not true, it’s not true, I don’t believe it, it’s
not true!’ sometimes when people actually even go to view
the body, spend time with the person who’s died, they with
great passion say, ‘That’s not my husband, it can’t
be!’ In other words, it’s the proverbial ‘Methinks
they protestest too much’. In fact if it wasn’t their
husband, they wouldn’t be doing that, they’d say,
‘No, wrong bloke, must be someone else.’ So there’s
a clear indicator from their passion that this is not denial,
they’re actually registering the truth.

And if we go to the other extreme and look at acceptance, you
know this linear model says you should go in a straight line towards
acceptance, ‘acceptance’ in general terms means ‘feel
OK about’. And I think well why should this person feel
OK about? And I think you need to distinguish the difference between
acceptance and acknowledgement, that generally I hear a husband
in particular say, ‘You know, my wife just can’t accept
that he’s died’, and I think What do you mean? Does
she not know that he’s died? ‘Well yes, no she knows’.
Does she acknowledge that he’s died? ‘Oh she’s
sad all the time’. OK, then what do you mean by acceptance?
‘Well, she’s sad all the time’. And I say, ‘Well
OK, maybe we need to reframe, because she’s acknowledging
he’s died and acceptance may or may not ever occur. Maybe
she’ll never feel OK about the fact that he’s died,
but it doesn’t mean she can’t accommodate her grief.’

Norman Swan: Another thing
people talk about and suggest is a significant event, if you like
in the bereavement/grieving process, is that they weren’t
there when the person died or in a sense they never said goodbye,
and some theories of grief say that’s really important.

Mal McKissock: I think it’s
important to have the opportunity to spend time with the person
who has died. Not to say goodbye per se, but to spend some more
time with that person who has died. And people often ask why is
it important to spend time with someone who has died? And I say
it’s not; it seems to be important to be able to spend some
more time with someone you love. Some of those people happen to
be dead. You’re not going because they’re dead, you’re
going because they’re special, they just happen to be dead.
So it’s actually a chance to spend one more moment with
them.

Norman Swan: If you don’t
get that moment?

Mal McKissock: Well it may
or may not, that’s one of those variables, so what we’re
saying is let’s encourage as many as possible in the most
creative and gentle way possible, so that we make sure we include
those who would be at risk if they don’t. But we actually
can’t predict in advance who they’ll be. So we’re
saying let’s be inclusive, let’s do this with children
and adults and let’s do it with husbands and wives. But
what people do when they’re inviting someone to spend time
with the person who’s died, they say it in a different context
than the one you mentioned. They prescribe to people, ‘You
need to say goodbye.’ And if my tone is patronising, it’s
because I think that’s how it sounds often but it’s
also prescriptive because they’re telling them what to do.
‘You have to say goodbye’. And I kept thinking, Why?
What if you say hello? What if you say I love you? Or what if
you even say, I’m angry at you, you bastard. It doesn’t
matter what you’re saying because that’s part of your
relationship, but I’m concerned about the prescriptive nature
‘You need to say goodbye’. And I know people do that
in earnest, but I flippantly hear their voice sometimes later
when an individual didn’t get to ‘say goodbye’,
they acquire this musicality in their voice and they often hum
‘Mmm, they didn’t say goodbye’. This really
deep and meaning diagnostic phenomena, ‘Now I know why they’re
grieving, they didn’t say goodbye.’ I think no, it’s
much more complex than that. What they say doesn’t matter.

Norman Swan: What other myths
do you think people carry in their head that could interfere with
the helping process, or the accommodating process?

Mal McKissock: I think the
big one is the notion of letting go, because again, if you come
back to the linear model a sort of staged theory of grief, it
implies you need to sever the relationship and move on with your
life. So around that we’ve built up these clichés,
you know things like, Buck up, think of the kids, pull yourself
together, every cloud’s got a silver lining, it’s
God’s will, it’s fate, it only takes time, you’re
young enough you can get married again and have another baby,
anyway she had a good innings. They’re all those things
that are suggesting you should sever your relationship and get
on with the rest of your life. Now what we know is that people
do get on with the rest of their life. I mean you can’t
not get on with the rest of your life, that’s what they’re
doing. But what we’ve found over the last 25 years or so
is that people maintain a relationship with the person who’s
died. So what we’re saying now is You don’t have to
let go. People die, but your relationship with them lives forever.
It’s called the memory. So unless you’re doing brain
damage, now that’s what people want you to do. People think
that the bereaved, in order to let go, should erase their memories.
To do that you’ve got to have the proverbial ‘frontal
lobotomy or bottle in front of me’. You know, you’ve
got to do permanent brain damage to do that. But what they learn
is you shouldn’t verbalise, externalise or articulate the
fact that you still have a relationship in your heart. And what
we’re now finding is let’s talk about it, there is
a way to allow this person to validate that relationship, and
that’s what memorabilia is.

You only have to look in Australia a few years ago when we had
the Victory in the Pacific celebrations, and there were all these
old diggers who were expressing their passion about their mates
who died, there was real grief, but there was real relationship,
and here with these Australian men who were in a relationship
with a person who had died, I didn’t hear any Australian
say, ‘Oh, unresolved grief’, and if it’s OK
for diggers 50 years afterwards, why isn’t it OK for a widow,
or a bereaved child 50 years later to still mourn for that person?
They’re not not living, they’re living with their
grief.

Norman Swan: But as somebody
who wants to help the person, or to use your phrase, help them
accommodate their grief, I think that’s how you talk about
it, you want to be able to help them move on and not become bolted
on to their grief so that they become paralysed by it.

Mal McKissock: That’s
true, but I think it’s one of those myths. It is incredibly
rare to see someone like that, paralysed. I mean it’s a
good term, because it differentiates from all the other passions.
Paralyse, you know, generally speaking you ask any health care
practitioner ‘When was the last time you saw someone paralysed
by their grief?’ It’s going to be fairly rare. I understand
it’s a fear, but I think that people see as interchangeable
the sense of paralysis with the repeated telling of the story,
they assume because someone repeats the story that they are in
fact paralysed. And that’s untrue. What they’re doing
–

Norman Swan: Well by paralysed
you mean not moving on, not achieving things in their life that
they might otherwise achieve, as people around them might say.

Mal McKissock: Yes but I’m
still looking, according to whose game plan? We need to look for
the bereaved person, by and large it’s a matter of relearning
the world, and you’re starting from square one, because
this is the first time you’ve actually been here. This isn’t
repetitive, this is the first time you’ve been here, and
every step you’re relearning the world. And that’s
really hard, you feel incredibly vulnerable, you’re very
regressed, in other words you have the vulnerability maybe of
an 8 to 15 year old, and you’re on your own. No-one’s
walked your path before. Contrary to popular myth. You know, this
is the first time you’ve done it over this death, and so
it’s a big struggle. So in terms of telling the story, people
need to sort out their new relationship with the person who has
died. When you talk about memories, when you remember, when you
bring the passion of relationship back into the present, biochemically
you’re actually changing what’s happening in your
body. It’s sort of emotional respite. You’re changing
the biochemistry, you’re feeling passion, as you remember
joyous moments you feel joy, even in the midst of grief. So what
we’re trying to do is help this person live with their grief,
live with their sadness and parallel it with joy and relationship,
as opposed to put that behind you and get on with the only important
thing in life, which is joy. That’s a myth.

Norman Swan: So the process
is drawing the past into the present?

Mal McKissock: Yes. Enabling
it, because it is there, as people go to bed at night and remember
this time last year my husband was beside me. I mean they’re
doing it anyway. What we’re doing is validating it and normalising
it and putting it in the context of the whole storyline. Now when
we talk about reflecting on when they first got married, or when
you first found out you were pregnant with this baby who at the
age of 22 died, you know, let’s build that in, put that
time line in perspective.

Norman Swan: What do you do
with that once you’ve got it?

Mal McKissock: Well it’s
actually a process. You don’t do anything with it. For instance,
one of the keys in it, if I’m interviewing someone I’m
trying to make a differential diagnosis between a depression from
a clinical perspective and what I would call passionate sadness,
to the, certainly the unskilled observer, and often the skilled
observer, they look the same. But when I talk to a bereaved person
about their relationship with the person who’s died, and
we meander in a storytelling, intimate way through the life of
that person, what I see is the joie de vivre they bring to this
moment, joy. And in that moment I know this is a clinical differentiation
between passionate sadness and depression, because a clinically
depressed person can’t touch their joie de vivre, and it’s
very easy to do, but people are scared to do it in case they upset
this person. Or they want to focus on the fact that someone is
dead, to drive that home, and I think the bereaved know they’re
dead.

Norman Swan: So if I’ve
heard you correctly you don’t think there’s a box
which you can call normal grieving.

Mal McKissock: Not unless I
was totally flippant about that, and I’d have to add a whole
lot of things, because it’s like if I come back to the Chaos
theory: we can talk about what summer is like in Australia, right?
so there is a normal summer. But what is any one day like in that
summer? I’ve got no idea, we can’t predict. The meteorologists,
that’s how Chaos theory came about, the meteorologist trying
to predict weather, and they realise they can’t so they
come up with a theory instead. Grief is like that. It’s
deterministic chaos though. What we know about grief, and the
weather, that summer generally in Australia is warmer than winter,
so it’s deterministic, there are limited variables. But
still so many variables that are independent to each individual
that we can’t predict their path. But we can say that under
these conditions they will accommodate this grief in their life,
but their life will never be the same again. And therein lies
the problem, because everyone wants to get them back to where
they were before as a sign of wellbeing. And I say, ‘You
can’t do that.’ You can’t say to a bilateral
amputee ‘You will be the same again.’

Norman Swan: But tell me what
well accommodated grief looks like. How do you recognise it when
you see it?

Mal McKissock: At the risk
of talking around the point, I first of all have to define what
is well adjusted life. You know that’s a complex sentence,
but it’s in accordance with that. That what we’ll
find that we talk about the newly bereaved, meaning the first
two years of their bereavement, as opposed to the first two weeks,
or month that everyone else sees. And we’re saying, ‘It’s
likely to take the average person maybe up to five years to accommodate
this experience in their new life. So let’s slow down.’
So when we’ve got that sort of time line we’re saying,
gradually bereaved people begin to demonstrate interest in others.
Gradually they reinvest in the world. So at a period of time,
you might hear them saying, ‘I went out to dinner the other
night and I didn’t enjoy it at all.’ And I say, ‘No,
but I remember two months ago you couldn’t even go out to
dinner.’ So we’re not using enjoyment, we’re
using behavioural change, which is a very subtle thing. But I
can’t then say ‘The sooner you go out to dinner, the
sooner you’ll get over your grief.’

Norman Swan: What should be
in the GP’s toolkit to use a rather mechanistic metaphor,
for approaching their patients who have been bereaved.

Mal McKissock: First, I wish
there could be an understanding of Chaos theory, that right, this
isn’t like a disease process. Secondly I think if we had
the longer interview time where you could actually engage with
this person specifically around their bereavement, not the symptoms
like sleeplessness, loss of appetite, those sort of things, even
constipation can be a symptom of bereavement. You know what we
know in bereavement that you’re excreting endogenous opioids,
and we know that opioids cause constipation, so we can reasonably
understand that bereaved people can get constipated. But instead
of just attending to their bowels or their sleeplessness, let’s
have a look at this as a working whole. And so if you can just
slow down, what we do first of all engaging with a patient, you’ve
got to know them a little bit.

Norman Swan: What you’re
going through now is a kind of a process you should have in your
head.

Mal McKissock: Yes. And contract
for a specific period of time, your 20 minutes or your half-hour
if you had that luxury, and then what we call a brush stroke;
in the exploration, what I want to find out is who died, how they
died, did they get a chance to spend any time with them after
they died, how was the funeral, and how has time been since. And
the time since doesn’t matter if it’s three days or
three years. But if you go through that, it’s not hard to
remember, because it’s linear.

Norman Swan: And why do you
ask about the funeral?

Mal McKissock: Well part of
that is looking at one of the risk factors, which is lack of reality.
Did they get a chance to participate in a rite of passage, which
for them was meaningful. The nature of it doesn’t matter,
but was it meaningful to them. And what you might hear people
saying ‘Oh I don’t know, I mean the doctor gave me
some medication; I took it, I don’t remember anything about
it.’ And that’s when I already think, ‘Oh, oh,
there’s no rite of passage, which is a public expression.’

Norman Swan: But isn’t
that saying goodbye, a part of saying goodbye?

Mal McKissock: It could be,
and metaphorically speaking it could be if we accepted that goodbye
–

Norman Swan: That you brought
it out into a rite of passage, rather than a simple ‘I sat
by the bedside and held his hand’.

Mal McKissock: Yes, because
I think that’s one act in the rite of passage which starts
from the death, or maybe for some people prior to the death, and
continues afterwards. It’s not merely one moment in time.

Norman Swan: Sorry, I interrupted
you there. Go on with your process.

Mal McKissock: Well again,
remembering what I just said is not hard, because we’re
going from the death to the viewing as it were, though I never
use that word, from the viewing to the funeral, to the time since.
That’s easy to remember because that’s linear. Very
few people have a funeral before someone dies, you know, so you
can remember that bit. But I only do that what we call a brush
stroke so I know what they’ve been through. I say, ‘I
need to know a little bit about what you’ve been through
so I can understand what you’re going through.’ But
in there I’m going to pick up a lot of free information.
The funeral was terrible, or let’s say one woman I worked
with whose husband was a naval officer, and the Navy insisted
on organising his funeral, wanted to have the cathedral because
it was a big do, he was an Admiral, and she just wanted a little
local church. But went along, because she’s incredibly vulnerable,
very hard to assert herself, had the big navy do. Later on I’m
seeing her, she says ‘I feel like they’ve buried the
Admiral, but I don’t know where my husband is.’ Boom-boom.
That’s the thing. So the rite of passage is me saying publicly,
this event has happened in my life and I need the collective to
be aware, to share a moment in time with me. And that’s
that moment in time.

Thereafter, when I’ve got the brush stroke of that, there
are going to be lots of detail I could go into which I choose
not to. Because now what I’m saying is we want to do the
thing that most people don’t do, because they believe they
can’t do. And metaphorically what we’re going to do
is, we’re going to bring the deceased to life. Not resurrect
them, but more in sort of in Hebrew, you know, l’chaim –
‘To life’, we’re going to bring them to life.
So what I do, and it would be very clearly indicated if people
do what I just said: at a point this person will say to me, Mal,
I just miss him so much, I just wish he was here. Now to me, that’s
the biggest sign I’ll ever get. Bring him back. People say
it all the time, and if you just listen they will say when the
time is right, bring him back. So I’ll say, ‘OK, it
would help me now to get to know him a lot better, because if
I don’t know your life with him, it’s hard to understand
your life without him.’ So I slow down, and I want to get
to know him well. Now to get to know him well, it doesn’t
matter if it’s a stillborn baby or a 95-year-old grandfather,
what I need to bring from inside of me is the value of doing this.
Watch the change in this person, and if I ask this mother of a
stillborn baby, ‘Tell me about your pregnancy. Tell me when
you had your baby safely tucked away inside.’ And I can
even go back before she was pregnant: ‘What was it like
planning the funeral?’ Or I can go back to her adolescence
when she first started menstruating, ‘What was it like when
you found out that that means that as woman you might be able
to have a baby?’ I can go back to infancy when she put clothes
on a bantam chook, because that’s where this baby began
as an emotion, it’s emotional gestation.

Norman Swan: So many was of
telling the story of that baby.

Mal McKissock: Absolutely.
But it started when she was putting clothes on the dolly peg,
you know, not when she just found out she was pregnant. Because
this woman has been building this baby up inside of her, and unless
I’ve walked that journey, how would I possibly understand
normal grief for her?

Norman Swan: How much expressed
emotion do you need, or do you have to see to be able to say to
yourself, ‘Well, this person needs a lot more help’,
or how much do you leave it to the person? In other words, to
what extent are you the passive receptacle for this information,
and how much do you come back?

Mal McKissock: Well my historical
perspective is now that people generally express 100% of their
passion. What I don’t know is what’s 100% for them.
I need to get to know this person a lot better before I know is
this as much as they show always, or is this less or more than
they usually show. Because if I saw someone who was usually demonstrative
and passionate and active and now they’re sort of labile,
I think something’s going on here I don’t understand.
And if I felt a big sadness in me, my way of working is just ‘Hearing
what you’ve been through I’m aware of how sad I feel,
and I didn’t even know your husband; what’s it like
for you now as we’re talking?’ Now in counselling
we call that facilitative self disclosure. I’m not telling
my story, but I’m being a real human being saying I’ve
got feelings as I listen to your story. And that’s not too
much self disclosure, that saves the client or the patient having
to wonder what’s going on for me. But it also means at the
end of the day I don’t get up to pussy’s bow with
emotion, because I’m also letting it out a little bit as
I go along. So then that person can feel normal without me having
to say You’re normal.

Norman Swan: Are there any
no-nos in that first interview, things that you shouldn’t
do?

Mal McKissock: Saying the clichéd,
obvious things like ‘I know what you’re going through’
or trying to compare their loss with someone else. Those sort
of things. At best they’re useless and at worst can be very
harmful because they feel compared, judged, those sort of things.
Minimising their grief, ‘It was only’, you know ‘It
was only a foetus’ or you know, sort of minimising their
grief. They wouldn’t be here if that were true. I think
being too ready to prescribe for them. I know people do go along
often to GPs, saying they need some sleeping tablets, some anti-depressants,
and my colleagues who are GPs say You know, it’s really
hard to refuse and I think, Of course it is, and you still should
do it. Like if someone came along wanting narcotics you’d
refuse, no matter how hard it was, unless they had significant
pain of course. And so I’m saying OK let’s find another
way. And say that’s one of our choices but before we go
there, let’s try this. We have people who are sent here,
who don’t want to come, their GP has sent them, or their
families, ‘Oh you really need help’ and they actually
come here against their will. And so counselling them against
their will when they don’t need it would I think be harmful
inasmuch as it’s patronising. And I think well that’s
nonsense. When I see someone who has been sent I first of all
establish How come you’re here? And a guy might say, ‘Oh
my doctor thought I should talk to someone because I haven’t
cried since my son died.’ So you’re the sort of guy
who cried fairly easily before your son died? ‘Oh no, not
me mate, I haven’t cried for about 40 years.’ And
I say, ‘Well why should you start now?’ And he says,
‘Well I don’t know, it’s just that the GP says
if I don’t, I’m going to break up.’ And I say,
‘Well, so your GP needed you to come along.’ He says,
‘Oh yes.’ And I say, ‘Well, OK you’ve
done that. You can tell your GP you came along, because you know
I think being here is a very intimate thing that you need to be
prepared to do and want to do. We don’t need to do any more,
you tell your GP you came along.’ But by and large then
people say, ‘Oh, well I’m here now.’ And I say,
‘Well OK, so you want to stay a while and talk?’ ‘Oh
well, that’s what you do isn’t it?’ So then
we’ll negotiate: I’m doing this helping people tell
their story. If you facilitate someone telling their story you’ll
never do any harm.

What will happen eventually, instead of just going into the loop
which is history they’ll swing into a loop that is about
what life would have been had he lived. You know, ‘We were
just planning to go on his holiday; we were going to move to Vietnam
because he had some work there as a sound recordist’ and
all that sort of stuff. And I say, ‘OK, well what do you
imagine it would have been like if you could have gone?’
and so she’ll now tell me the story of what would have been.
So gradually we’ll go into that loop, of what the future
would have been like. And what we find over time is the energy
dissipated in the history and the future as it would have been,
will actually dissipate. And she starts thinking, Oh, I thought
I’d enrol in a course at TAFE.’ She will actually
tell me that, I won’t prescribe that, ‘You’ve
got to get out and get interested’. No, she’ll tell
me when she’s doing that. And I will actually feel that
there is a significant shift towards reinvestment in life as she
is structuring it without him. But very rarely do I have to prescribe
it or describe it.

Norman Swan: Mal McKissock,
who, with his wife Di, runs the Bereavement Care Centre in Sydney.
This was an edited version of an interview I originally did on
the Rural Health Education Foundation Network for Rural Doctors
and Practitioners, but I thought it deserved a wider airplay;
I hope you agree.